True aneurysm of the brachial artery is a rare disease entity. The mechanism of aneurysm formation is considered to be compression of the arterial wall, producing contusion of the media and subsequent weakness of the wall and fusiform dilatation. It can be caused by arteriosclerotic, congenital, and metabolic disorders, and can be associated with diseases such as Kawasaki's disease. Doppler ultrasonography, computed tomography, arteriography, and selective upper extremity angiography may be performed for establishing the diagnosis of aneurysm. The best therapeutic option is operative repair, and it should be performed without any delay, in order to prevent upper extremity ischemic or thrombotic sequelae. Here, we report a case of recurrent brachial artery aneurysm with review of the literature.
A 7-year-old intact female Maltese dog presented with a history of bite wounds. Physical examination revealed labored breathing, four puncture wounds with subcutaneous emphysema of the thorax, and paradoxical respiratory movement of the right thoracic wall. On radiography, a segmental fracture of the right 7th rib and a single fracture of the 8th rib were evident on the dorsal thorax. An inward displacement of the fractured segment and contusion of the right caudal lung lobe were identified with computed tomography. A diagnosis of pseudo-flail chest was made. Exploratory thoracotomy revealed a full-thickness muscular defect, a marked discoloration of the right caudal lung lobe, a segmental fracture of the right 7th rib, and a single fracture of the right 8th rib. Necrotic tissues were removed using surgical debridement. The fractured 7th and 8th ribs were corrected using a single interfragmentary wiring technique. The thoracic wall was reconstructed using the latissimus dorsi muscle flap. Additional thoracic stabilization using a thermoplastic splint was applied to correct paradoxical respiratory movement. The external splint was removed 4 weeks postoperatively. There was no evidence of respiratory abnormalities 18 months postoperatively.
Purpose: Blunt cardiac injuries (BCI) have a wide clinical spectrum, ranging from asymptomatic myocardial contusion to cardiac rupture and death. BCIs rarely require surgical intervention, but can be rapidly fatal, requiring prompt evaluation and surgical treatment in some cases. The aim of this study was to identify potential factors associated with in-hospital mortality after surgery in patients with BCI. Methods: The medical records of 15 patients who had undergone emergency cardiac surgery for BCI between January 2014 and August 2020 were retrospectively reviewed. We included trauma patients older than 18 years admitted to Regional Trauma Center, Gachon University Gil Medical Center during the study period. Clinical and laboratory variables were compared between survivors and non-survivors. Results: Non-survivors showed a significantly higher Injury Severity Score (p=0.001) and Abbreviated Injury Scale in the chest region (p=0.001) than survivors. American Association for the Surgery of Trauma-Organ Injury Scale Grade V injuries were significantly more common in non-survivors than in survivors (p=0.031). Non-survivors had significantly more preoperative packed red blood cell (PRBC) transfusions (p=0.019) and were significantly more likely to experience preoperative cardiac arrest (p=0.001) than survivors. Initial pH (p=0.010), lactate (p=0.026), and base excess (BE; p=0.026) levels showed significant differences between the two groups. Conclusions: Initial pH, lactate, BE, ventricular injury, the amount of preoperative PRBC transfusions, and preoperative cardiac arrest were potential predictors of in-hospital mortality.
Chung, Tae Kyo;Hyun, Sung Youl;Kim, Jin Joo;Ryoo, EeIl;Lee, Kun;Cho, Jin Seung;Hwang, Sung Yun;Lee, Suk Ki
Journal of Trauma and Injury
/
v.18
no.2
/
pp.119-126
/
2005
Background: Blunt thoracic trauma in children has a high morbidity and mortality. In this study, we assessed the significance of the injury pattern, mechanism and initial status in emergency department on severity and prognosis in pediatric blunt thoracic trauma patients. Method: We retrospectively reviewed medical records and chest X-ray and CT images of 111 pediatric blunt thoracic trauma patients from October 2000 to June 2005. Data recorded age, gender, season, injury mechanism, injury pattern, associated injury, length of hospital stay and cause of death. Result: Of all 111 patients, 68 patients were injured by motor vehicle accidents, 30 were falls, 5 were motorcycle accidents, 3 were sports accidents and 5 were miscellaneous. In thoracic trauma, single injury of lung contusion were 35 patients and 32 patients had multiple thoracic injuries. Hospital stay in school age group were longer than preschool age group. The causes of death were brain injury in 9, respiratory distress in 4, and hypovolemic shock in 2 patients. Emergently transfused and mechanically ventilated patients had higher mortality rates than other patients. Patients required emergency operation and patients with multiple thoracic injuries had higher mortality rates. Conclusion: In this study, patients with combined injury, emergency transfusion, mechanical ventilation, emergency operation, multiple injuries in chest X-ray had higher mortality rates. Therefore in these pediatric blunt thoracic trauma patients, accurate initial diagnosis and proper management is required.
Objectives : The purpose of this study is to establish literatural evidence about thermotherapy and cryotherapy for Korean medicine through literatural review. Methods : Applicable paragraphs which were related to the thermotherapy and cryotherapy of cutaneous and muscle meridian were phrased from in "Yibujicheng(醫部集成) and "Dongyibaojian(東醫寶鑑)" where were archiving of Oriental or Korean medicine literatures. Searched paragraphs were analysed for establishing historical and theoretical bases of thermotherapy and cryotherapy in Korean medicine. Results : Thermotherapy of cutaneous and muscle meridian(經皮經筋溫熱療法) such as hot pack, warm water therapy, paraffin bath, ultrasound is originated from yu(慰) warm water(溫水) hot water(熱水). Matching indications are various pain conditions(caused by coldness(寒), hard-work(僗若), extravasated blood(瘀血), inflammatory skin disease, frostbite and several internal diseases. It also treats gynecological diseases and facial palsy. Diathermic therapy on acupuncture points(穴位照射溫熱療法) such as infra-red, microwave, shortwave is originated from huolu(火爐), wenlu(溫爐), xianglu(香爐), lamp light(燈火). Its objective is to improve the effects of herb medicine by aiding sweating or to treat the residual symptoms of fever disease or to care skin disease and pain from bone fracture, contusion. Cryotherapy of cutaneous and muscle meridian(經皮經筋溫寒冷療法) such as ice pack, ice spray, iced whirpool, cool water bath is originated from lengfu(冷敷), lengtie(冷貼), lengshiyu(冷石熨). Matching indications are contusions, animal bite injury, corn(肉刺) and (淋病), eye disease, nasal bleeding, hemorrhoid, inflammatory skin disease and chicken pox. Conclusions : Thermotherapy and cryotherapy of cutaneous and muscle meridian(經皮經筋溫冷療法) are the treatments which were used in Korean medicine from the ancient Korean medicine. As scientific equipments were originated from yu(慰), huolu(火爐), wenlu(溫爐), xianglu(香爐), lamp light(燈火). lengfu(冷敷), lengtie(冷貼), lengshiyu(冷石熨). It can be said that these are elements of Korean medicine. More rigorous studies are needed to establish clinical evidence about not only thermotherapy and cryotherapy but also the other physiotherapy of Korean medicine.
Kim, Eun-Seok;Kim, Pyung-Soo;Kim, Bum-Hoi;Shin, Jung-Won;Kim, Seong-Joon;Sohn, Nak-Won
Journal of Acupuncture Research
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v.28
no.3
/
pp.33-42
/
2011
Objectives : This study was performed to evaluate the effects of Scutellariae radix (SR) water extract on locomotor dysfunction induced by spinal cord injury (SCI) in rats. Methods : SCI was induced mechanical contusion following laminectomy of 10 th thoracic vertebra in Sprague-Dawley rats. SR was orally given once a day for 7 days after SCI. Neurological behavior was examined with the Basso-Beattie-Bresnahan locomotor rating scale. Tissue damage and nerve fiber degeneration were examined with cresyl violet and luxol fast blue (LFB) histochemistry. Using immunohistochemistry, cellular damages to neurons and nerve fibers were examined MAP-2. Results : 1. SR significantly ameliorated the locomotor dysfunction of the SCI-induced rats. 2. SR significantly reduced the number of motor neurons in the ventral horn of the SCI-induced rat spinal cord. 3. SR attenuated the reduction of nerve fiber shirnakage and degeneration of the SCI-induced rat spinal cord. 4. SR attenuated the reduction of MAP-2 positive cells in the peri-lesion of the SCI-induced rat spinal cord. Conclusions : These results suggest that SR improves the locomotor dysfunction of SCI by reducing degeneration of nerve fibers and motor neuron shrinkage in the ventral horn.
This study was conducted for the development of recording system of students' health problems, and for the application of International Classification of Health Problem in Primary Care(ICHPPC) as a tool of morbidity classification in school health care. The data were collected from 12th of September to 24th of September in 1988. The objects were composed of health problems written by 10 school nurses who take service in the elementary school. The results were as follows: 1. The features of students' health problmes. The health problems of students were 68 problems from the total numbers of 361 codes of ICHPPC. The 93.4% of health problems was contained in 20 descriptive diagnoses and 97.0% was contained in 30 descriptive diagnoses. According to frequency of main health problems, There were abrasion, scratch and blister(26.7%); disorder of stomach function, other disease of stomach and duodenum (20.4%); headache(10.6%); bruise and contusion (5.3%); acute URI (5.0%); laceration and open wound(4.6%); Insect bite and sting(4.0%); epistaxis(3.4%): abdominal pain(2.6%): superficial tissue(1.7%). Out of all health problems, Category 17(accident, injury and poisoning was 44.7%. and Category 9(digestive system Disease) was 22.2%. 2. Applicability of ICHPPC by the school nurses. School nurses used 68 codes, among the total number of 361 codes from ICHPPC. According to ICHPPC method, school nurses can classified more diverse health problems systematically and objectively than that in other studies on school nurses activities. ICHPPC was found as a useful and applicable tool of morbidity classification in the practice of school nurses.
Objectives : Assuming that the characteristic of meridian system has been similar to this of electric potentials in human body and that measurements of electric potential at well(井穴) and sea(合穴) points in branches of the twelve meridians(WSBTM) will be representative of measurements of the twelve meridians, to measure the electric potentials of 13 patients with Arthroncus of Knee(슬안풍<膝眼風>, AK), to find out the characteristic of meridian system in patients with AK. Methods : Electric potentials of well and sea points in the meridians in twenty one patients with the pain in the lion diagnosed as AK were repeatedly measured by physiograph(PowerLab). Measurements of those electric potentials were analyzed by factor analysis. Results : Their electric potentials at the left and right side were factors which are different from each side. In the left side, Factor 1 included Small Intestine, Pericardium, Spleen, Kidney meridian, and Factor 2 included Heart, Tripple Energizer, Bladder, Liver meridian. Factor 3 included Large Intestine, Stomach, Gall bladder meridian, and Factor 4 included Lung meridian. In the right side, Factor 1 included Heart, Pericardium, Tripple Energizer, Spleen, Bladder meridian and Factor 2 included Lung, Liver, Gall bladder meridian. Factor 3 included Small Intestine, Stomach, Kidney meridian and Factor 4 included Large Intestine Meridian. Conclusions : The electric potentials of AK differ from those of normal bodies as well as of bodies with other diseases-shoulder lesions, waist lesions, Lumbago due to Strain and Contusion-. Thus electric potentials of well and sea points might be the representative meridian to show their characteristics.
Kim, Bang-Oul;Kim, Kyoung-Sun;Jeon, Hong-Yeol;Kang, Hwa-Jeong;Kim, Jeong-Sang;Hong, Seok;Kim, Yong-Jin
The Journal of Internal Korean Medicine
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v.23
no.2
/
pp.191-201
/
2002
Objectives : This study was designed to investigate the effects of Yukmijihwang-tang on contusion of the mice induced with medicine. Methods : I observed the effects of light and electron microscopes. and examined hematological changes and VEGF-immunohistochemistry. Results : Hematology: Leukocytes were increased significantly in a control group of mice compared with the experimental group. Light microscope : A few neurons were condensed in the 7-day experimental group, but condensed remarkedly in the 3-day control group. Most glial cells were observed in the 3-day experimental group. Edema and dilatation of vessels occurred significantly in the 3-day control group, and these results occurred weakly in the 7-day experimental group. VEGF-immunohistochemistry : VEGF-immunohistochemical reactivity for the glial cells was the highest in the 3-day experimental group, and immunoreactivity for the vessels and neurons highly increased in the 7-day experimental group. Electron microscope : In the 3-day control group, protoplasmic astrocytes concerned with angiogenesis contained weakly developed rough endoplasmic reticulum. and a few of glial filaments were observed. In the 7-day experimental group, the bundles of glial filaments were found in the cytoplasmic process of astrocytes. Conclusion : medication using Yukmijihwang-tang of mice contused by medical stress is highly effective in inflamatory response, curing cell damage and angiogenesis.
In Everland Zoological Gardens, the mortality by extrinsic cause in non-human primates during 1976∼1999 were retrospectively analyzed based on the clinical charts and/or autopsy reports. The number of deaths from extrinsic factor was 61 among a total of 161 monkeys which were died during that period. Among 61 monkeys of death from extrinsic factor, the number at a detailed cause were as follows: strangulation, 17(27.87%); accident fall, 15(24.59%); suffocation, 13(21.31%); drowning, 7(11.48%); death from pressure, 2(3.28%); collision, 2(3.28%); sunstroke, 1(64%); starvation, 1(1.64%); freezing to death, 1(1.64%); contusion, 1(1.64%). The number of deaths from extrinsic factor was 39 among a total of 81 squirrel monkeys which were died during that period. Among 39 squirrel monkeys of death from extrinsic factor, the number at a detailed cause were as follows; suffocation, 11(28.21%); accident fall, 8(20.51%); strangulation, 7(17.95%); drowning, 7(17.95%); death from pressure, 2(5.13%); starvation, 1(2.56%); collision, 1(2.56%). The number of deaths from extrinsic factor was 14 among a total of 50 Japanese macaque died during that period. Among 14 Japanese macaque from extrinsic factor, the number at a detailed cause were as follows; strangulation, 7(50.55%); accident fall, 6(42.85%); suffocation, 1(7.14%). It was considered that far facilities, adequate space and suitable indoor temperature are needed for the prevention of deaths of extrinsic cause at the monkey raising in zoological gardens or research center.
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